A study of 1196 acute appendicitis patients revealed that 38.9% had complicated cases. Key predictive factors include male gender, age, duration of abdominal pain, temperature, abdominal tension, neutrophil count, and the presence of appendiceal fecaliths. The research developed a predictive nomogram that aids clinicians in distinguishing between complicated and uncomplicated cases, potentially improving surgical outcomes […]
Author: STITCHES Newsletter
Standardized protocols reduce opioid use in surgical patients
Standardized electronic order sets significantly decreased inpatient opioid use for emergency general surgery patients from January 2019 to June 2023. The total morphine milligram equivalents (mme) per patient and average mme per opioid dose decreased notably, demonstrating sustained effects across administration routes. Additionally, lower mme medications were increasingly ordered, and multimodal regimens expanded, all while […]
Circular skin closure significantly reduces surgical site infections
A systematic review and meta-analysis revealed that circular skin closure (CSC) markedly decreases the rate of surgical site infections (SSI) following stoma closure compared to primary sutures (PS). Researchers found that only 4% of patients using CSC developed SSI, in contrast to 27% in the PS group. This analysis, which included eight randomized controlled trials […]
Statistical cure model developed for HBV-associated hepatocellular carcinoma
A novel risk-stratification model for statistical cure after hepatectomy in hepatitis B virus-associated hepatocellular carcinoma (HBV-HCC) reveals an overall cure probability of 21.2%. The study identified eight independent risk factors, including high viral load and macrovascular invasion, that significantly influence outcomes. Low-risk patients achieved a 30.3% initial cure rate, with a remarkable 95% probability of […]
Prehabilitation reduces postoperative pneumonia in esophagogastric surgery
A multimodal prehabilitation regimen improved postoperative outcomes for patients undergoing esophagogastric cancer surgery. Of 94 participants analyzed, those who completed at least 2 weeks of structured prehabilitation showcased a significant reduction in postoperative pneumonia compared to the control group. This research underscores the importance of tailored prehabilitation strategies in enhancing recovery and addressing complications in […]
Optimal Pain Management After Surgery is Under Study
The CARES trial aims to determine the effectiveness and safety of analgesic regimens in postoperative pain management. Enrolling adults undergoing elective surgeries, participants are randomized to receive either NSAIDs or low-dose opioids, complemented by acetaminophen. The primary outcomes include patient-reported pain intensity and side effects within the first week post-surgery. Secondary outcomes will assess various […]
Extraperitoneal colostomy reduces complications after laparoscopic APR
A systematic review involving 1,002 patients revealed that extraperitoneal colostomy (EPC) significantly lowers the incidence of parastomal hernia compared to transperitoneal colostomy (TPC) after laparoscopic abdominoperineal resection for rectal cancer. The EPC technique also showed reduced rates of stoma retraction, prolapse, and overall stoma-related complications. Importantly, both approaches did not differ significantly in total operative […]
Financial toxicity is prevalent among hepatopancreatobiliary cancer patients
An analysis of the National Health Interview Survey highlights significant financial toxicity among U.S. patients with hepatopancreatobiliary (HPB) cancers. Of 5.6 million adults, 10.1% delayed medical care due to cost, while 8.4% could not afford necessary treatment. Uninsured patients faced markedly higher odds of financial challenges, and non-white patients were also more likely to delay […]
Robotic pancreatoduodenectomy shows improved outcomes with surgeon experience.
A study assessed the learning curve of robotic pancreatoduodenectomy among a first-generation surgeon. It identified three phases: competency, proficiency, and mastery, with significant reductions in operative time and complication rates as experience increased. At 90 days, severe morbidity was 24% and mortality was 5.4%. Mastery led to improved lymph node harvest, margin status, and better […]
Minimally invasive surgery enhances outcomes for liver resection
A retrospective analysis of 164 liver resections for primary intrahepatic lithiasis demonstrated that minimally invasive techniques, which increased to 60% of surgeries, significantly reduced morbidity and hospital stays compared to traditional open surgery. Key complications included a 16% rate of bile fistula and 30% of septic events. Long-term follow-up showed a 20% recurrence linked to […]